Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder.
irritable bowel syndrome (IBS) is one of the functional gastrointestinal disorders and the most common functional bowel disease in clinical practice. It is a clinical syndrome that includes abdominal pain, abdominal distension, change in bowel habits, abnormal stool characteristics, and mucus stools, and excludes organic diseases that may cause the above symptoms, and is characterized by persistence and recurrence. It is characterized by persistence and recurrent attacks. The prevalence of the disease is 8-10% in young and middle-aged people. IBS is a chronic or recurrent gastrointestinal disorder that involves the esophagus, stomach, bile duct, small and large intestine, and anorectum, but its main target organ is the intestine, and although IBS is not life-threatening, it can affect work and life to varying degrees, reducing quality of life and taking up limited medical resources.
IBS is usually insidious in its onset. Symptoms are recurrent or chronic and can last for years to decades. The reason for consultation is often due to the following reasons: severe pain, urgency of defecation, excessive stool frequency, bloody stools, anxiety, fear of cancer, etc. Clinical symptoms are diverse and vary in severity. All symptoms can be seen in organic gastrointestinal disease. Although there are individual differences in the symptoms, the onset pattern and form are mostly fixed for a specific patient. The frequency of IBS symptoms varies greatly from patient to patient, with some patients having daily or continuous episodes of symptoms, while others may be asymptomatic for long periods of time.
Abdominal pain or discomfort is a major symptom, and about 2/3 of patients have abdominal pain.
One of the symptoms complained of by IBS patients is abdominal pain, mostly accompanied by abnormal bowel movements and relieved after defecation, clinically suggesting that the symptoms mainly originate from the colon. The abdominal pain or discomfort can occur anywhere in the abdomen and can be limited or diffuse, but is most often located on the left side of the abdomen, with the left lower abdomen being the most common. Patients often have other symptoms reflecting colonic dysfunction (e.g., abdominal flatulence, urgency to defecate, and a feeling of incomplete evacuation). Abdominal pain can often be triggered by a meal and may be relieved by a bowel movement. Nocturnal awakening from sleep with pain is extremely rare. Patients with depression often have early awakening in the morning, and after waking up, they may notice abdominal pain and complain of painful awakening.
2.Changes in bowel habits Abnormal bowel movements generally include abnormal number and abnormal shape. The number of bowel movements less than 3 times/week or more than 3 times/day, thin stools, watery stools and dry and hard stools are considered abnormal bowel movements.
3.Abdominal distension
Abdominal distension and discomfort is a common complaint in patients with all types of IBS, and is usually worse during the day and relieved at night after sleep. Abdominal circumference does not generally increase. It is often accompanied by eructation or increased gastrointestinal gas, and some patients’ abdominal distension is so severe that they can hardly tolerate it and have to loosen their trouser bands to relieve it.
4.Extra-intestinal manifestations of IBS
Patients with IBS have a high rate of non-colonic and extra-gastrointestinal symptoms; nearly half of them have upper gastrointestinal symptoms such as heartburn, early satiety, nausea and vomiting. Moreover, IBS symptoms can overlap with other functional gastrointestinal disorders (e.g., functional dyspepsia), or even manifest as a change of the main symptoms to other functional gastrointestinal disorders. Similarly, patients with IBS may also have manifestations of other systemic diseases, such as headache, non-cardiogenic chest pain, functional dyspepsia, low back pain, urinary difficulties, chronic fatigue syndrome, etc., so that patients often consult other clinical departments.
5.Psychiatric characteristics
The symptoms of IBS are closely related to psychiatric and psychological factors. Patients are often accompanied by depression, anxiety, nervousness, paranoia, hostility and other psychiatric symptoms. patients with IBS have similar neuroticism as psychiatric patients, often showing high levels of depression, anxiety and worry about the body. The degree of these symptoms is much more severe than in patients with common gastrointestinal disorders, often to the extent that a psychiatric disorder can be diagnosed. They report and may subjectively experience more symptoms of abdominal pain than patients with other similar intestinal disorders.
6. Triggers for the appearance or exacerbation of IBS symptoms
IBS is often triggered by psychiatric factors or encounters with stressful conditions. Some patients also have different degrees of psycho-psychiatric abnormalities, such as depression, anxiety, nervousness, paranoia, hostility, etc.. Psychiatric factors mainly affect the frequency and severity of symptom onset, overall health status, utilization of health resources, and clinical outcome of IBS patients. In addition, symptom recurrence can be induced by improper diet, exertion, systemic or gastrointestinal infections, and inappropriate medication use.